E-Cigarettes Worth Try to Quit Smoking, Heart Group Says

The heart association said e-cigarette use should be supported as a quitting mechanism only if smokers are intolerant of, fail at, or refuse other options. Photographer: Chris Ratcliffe/Bloomberg

Aug. 25 (Bloomberg) -- Electronic cigarettes are worth
trying as a last option for smokers seeking to quit, the biggest
U.S. heart health advocacy group said.

The American Heart Association, in a policy statement
released today, said physicians shouldn’t discourage e-cigarette
use as a last resort to drop a smoking habit.

E-cigarettes have leaped in popularity and the U.S. Food
and Drug Administration is weighing regulations for the devices
in a market that could total as much as $5 billion next year.
Doctors are uncertain what advice they should offer about the
products, said Aruni Bhatnagar, lead writer of the policy
statement from the Dallas-based nonprofit group and a professor
of medicine at the University of Louisville in Kentucky.

“If people cannot quit at all and have tried everything in
the field, we would not discourage them,” Bhatnagar said of e-cigarettes. “It’s not something that we would suggest.”

“We do not know for sure and the jury is still out whether
or not these e-cigarettes are safe to use, so we do not say that
they’re safe,” he said in a telephone interview.

E-cigarettes typically contain nicotine and none of the
tobacco or tars, arsenic and other chemicals found in
traditional cigarettes. The devices are battery powered and
produce a vapor to mimic smoking. Lorillard Inc. agreed to sell
the popular Blu e-cig brand to Imperial Tobacco Group Plc as
part of its proposed acquisition by Reynolds American Inc.

Mitch Zeller, head of the FDA’s Center for Tobacco
Products, said the agency is keeping an open mind about whether
the devices have a health benefit, such as helping someone stop
smoking.

Last Chance

The heart association said e-cigarette use should be
supported as a quitting mechanism only if smokers are intolerant
of, fail at, or refuse other options.

“However, subjects should be informed that although e-cigarette aerosol is likely to be much less toxic than cigarette
smoking, the products are unregulated, may contain low levels of
toxic chemicals, and have not been proven as cessation
devices,” according to the heart group’s policy statement.

Cigarette smoking has been linked to coronary heart
disease, which can lead to heart attacks; increased blood
pressure; and a higher risk of blood clots, according to the
heart association. Nicotine can cause a short-term increase in
blood pressure and heart rate, the group said.

Current Studies

The National Heart, Lung and Blood Institute gave the
University of California at Riverside, almost $34,400 last year
to study the health effects of e-cigarettes on developing
embryos and adults, according to a database of National
Institutes of Health research. The study is slated to end in
December 2016.

The National Institute on Drug Abuse also gave the
university $205,200 to study whether electronic cigarettes are
less harmful than traditional smokes.

Research so far hasn’t shown electronic cigarettes work
better than other products as a cessation device.

“Current evidence suggests at best a modest effect on
cessation, likely equal to or slightly better than that of
nicotine patches without behavioral support,” according to the
heart association’s policy statement.

Because of the lack of long-term data on e-cigarette use,
the organization suggests smokers who use them to quit set a
date to terminate their e-cigarette use and not rely on the
devices indefinitely. The policy statement still advises tobacco
use surveys at doctor visits and workplace health screenings to
include questions on e-cigarette smoking.

Slowing Sales

While sales of the devices could reach $5 billion next
year, up from $1.5 billion in 2013, according to Kenneth Shea, a
Bloomberg Intelligence analyst, their use appears to have
stalled as traditional smokers reject the products and
competition increases from generic vaporizers that can be
refilled with liquid nicotine.

Sales of electronic smoking devices declined 2.9 percent in
the four weeks ended May 18 compared with the previous year and
slid twice as fast the following month, according to data from
Chicago researcher IRI.

The dip also comes after the FDA proposed in April to
expand its regulation of cigarettes to the electronic versions
and cigars. The agency would restrict sales to minors, ban free
samples and require nicotine addiction warnings for the products
though it didn’t prohibit TV advertising or flavored products.

The American Heart Association was part of a joint response
to the FDA’s proposal calling on the FDA to ban flavors and
marketing to youth. The heart association also said e-cigarettes
should be included in states’ smoke-free laws that prohibit
smoking in certain places to limit second-hand exposure.